AGING AND DISABILITY SERVICES ADMINISTRATION
September 15, 2004
ADSA: AFH #2004-007
MAA PRESCRIPTION DRUG PROGRAM
Dear Adult Family Home Provider:
In order to comply with legislation passed by the legislature and signed by the Governor this year, the department’s Medical Assistance Administration (MAA) is currently working on expanding a program to control the costs of prescription drugs for individuals who receive drugs under public programs, such as Medicaid. This program is called the Washington State Prescription Drug Program (PDP).
The department’s Medicaid program, Department of Labor & Industries and Health Care Authority are participating in the PDP. The PDP currently involves prescription drugs purchased by the three agencies on a fee-for-service (FFS) basis.
The law requires the three agencies to develop a single statewide-preferred drug list (PDL) that each of the agencies will use. As of July 31, 2004 the PDL consisted of 11 classes of drugs. Approximately seven drug classes will be added to the PDL by January 1, 2005, and it is anticipated that an additional seven drug classes will be added by January 1, 2006, completing the state’s PDL with 25 classes of drugs. Last fall the program included opioid medications such as Duragesic patches, this fall it is expected that atypical-antipsychotics will be included.
Enclosed is a monograph from the MAA outlining some facts about the program, some of which relates specifically to the prescriber, usually a physician. “DAW” means “dispense as written”.
If physicians, attending your residents, are unaware of this program please provide them with this information. To obtain more information by e-mail go to http://rx.wa.gov/, or you may contact Siri Childs, MAA’s Pharmacy Consultant, at (360) 725-1564.
We hope you will find this information helpful. Thank you for your continued service to the long-term care residents in Washington.
Sincerely,
Patricia K. Lashway, Director
Residential Care Services
Enclosure
What’s Going On?
Legislation approved by the Washington State Legislature, and signed into law by Governor Gary Locke, supports the creation of the Washington State Prescription Drug Program known as Rx Washington. Rx Washington was established in order to develop an evidenced based prescription drug program to identify preferred drugs; make prescription drugs more affordable to Washington residents and state health care programs; and, increase public awareness regarding the safe and cost-effective use of prescription drugs.
What’s in it for me?
If you are an endorsing practitioner (see below) and you indicate DAW on the script you get the drug without hassles. If you indicate substitution permitted for a non-preferred drug therapeutic interchange is permitted by the pharmacist. Non-endorsing providers do not have this safe harbor and will be subject to administrative controls regardless of DAW on the script. Think of it like generic substitution for brand name drugs.
Where can I get more information?
What is an Evidence Based Prescription Program
Senate Bill 6088 creating Rx Washington directs agencies administering state purchased health care programs to cooperatively take actions to control costs without reducing the quality of care when purchasing prescription drugs. The legislation outlines three major components to the Evidence Based Prescription Drug program: the Preferred Drug List; the Washington State Pharmacy & Therapeutics Committee, and the Endorsing Practitioner - Therapeutic Interchange Program.
Endorsing Practitioner - Therapeutic Interchange Program
Under this new legislation, state-operated prescription drug programs are required to develop a process that allows physicians and other prescribers to endorse the Washington Preferred Drug List, and requires pharmacists to automatically substitute the preferred drug for nonpreferred drugs prescribed by these practitioners unless the prescription is for a refill of an antipsychotic, antidepressant, chemotherapy, antiretroviral, or immunosuppressive drug, or unless the prescription is written as DAW, in which case the pharmacist shall dispense the prescribed nonpreferred drug. This endorsement process is intended to streamline administrative procedures and make prescription drugs more affordable to Washington residents and state health care programs.
